Donald P R, Schoeman J F, Beyers N, Nel E D, Carlini S M, Olsen K D, McCracken G H
Department of Paediatrics and Child Health, Tygerberg Hospital, South Africa.
Clin Infect Dis. 1995 Oct;21(4):924-9. doi: 10.1093/clinids/21.4.924.
Concentrations of interferon gamma (IFN-gamma) in the lumbar cerebrospinal fluid (CSF) of 30 children (mean age, 27 months) being treated for stage III (16 children) and stage II (14 children) tuberculosis meningitis (TBM) were determined by ELISA. Nine children with stage III TBM and six with stage II TBM received prednisone (4 mg/kg). Concentrations of IFN-gamma in 73 CSF specimens (18 from the first week of therapy, 20 from the second, 19 from the third, and 16 from the fourth) were determined. The mean concentrations were 780 pg/mL in the first week of therapy and 554 pg/mL, 529 pg/mL, and 269 pg/mL in the second, third, and fourth weeks, respectively. Tumor necrosis factor alpha (TNF-alpha) and interleukin-1beta (IL-1beta) concentrations in 56 specimens from 23 of these same children were determined by ELISA. The mean CSF TNF-alpha concentration in 12 specimens obtained during the first week of therapy was 17 pg/mL, and the mean was 11 pg/mL during each of the subsequent weeks (14 specimens were evaluated in the second week and 15 specimens in the third and fourth weeks of therapy). Mean IL-1beta concentrations in these same groups of specimens were 52 pg/mL, 43 pg/mL, 42 pg/mL, and 18 pg/mL. No correlation could be shown between cytokine concentration and stage of disease, and no differences existed between those who did and those who did not receive prednisone. A significant decline in IL-1beta concentrations was shown during the 4-week period, but none in TNF-alpha or IFN-gamma concentrations was noted. Persistently high CSF INF-gamma concentrations in cases of TBM (as in cases of aseptic meningitis but not bacterial meningitis) at the time of diagnosis suggest an immune response fundamentally different from that in bacterial meningitis.
采用酶联免疫吸附测定法（ELISA）测定了30例（平均年龄27个月）正在接受治疗的Ⅲ期（16例）和Ⅱ期（14例）结核性脑膜炎（TBM）患儿腰椎脑脊液（CSF）中γ干扰素（IFN-γ）的浓度。9例Ⅲ期TBM患儿和6例Ⅱ期TBM患儿接受了泼尼松治疗（4mg/kg）。测定了73份CSF标本中IFN-γ的浓度（治疗第一周18份，第二周20份，第三周19份，第四周16份）。治疗第一周的平均浓度为780pg/mL，第二、第三和第四周分别为554pg/mL、529pg/mL和269pg/mL。采用ELISA法测定了其中23例患儿56份标本中肿瘤坏死因子α（TNF-α）和白细胞介素-1β（IL-1β）的浓度。治疗第一周获得的12份标本中CSF TNF-α的平均浓度为17pg/mL，随后各周的平均浓度为11pg/mL（治疗第二周评估14份标本，第三周和第四周评估15份标本）。这些相同组标本中IL-1β的平均浓度分别为52pg/mL、43pg/mL、42pg/mL和18pg/mL。细胞因子浓度与疾病分期之间未显示出相关性，接受泼尼松治疗和未接受泼尼松治疗的患儿之间也没有差异。在4周期间，IL-1β浓度显著下降，但TNF-α或IFN-γ浓度未发现下降。TBM病例（如无菌性脑膜炎病例，但与细菌性脑膜炎不同）在诊断时CSF中IFN-γ浓度持续升高，提示其免疫反应与细菌性脑膜炎有根本不同。
